Topics A to Z

As part of NEHA's continuos effort to provide convenient access to information and resources, we have gathered together for you the links in this section. Our mission is "to advance the environmental health and protection professional for the purpose of providing a healthful environment for all,” as well as to educate and inform those outside the profession.


On October 2, 2014, the Douglas County Health Department (DCHD) Lead Poisoning Prevention Program (LPPP) received a 61 μg/dL venous blood lead concentration (VBLC) report describing a 3-year-old female refugee. A VBLC above 45 µg/dL in a child less than 72 months requires an aggressive medical and lead hazard exposure intervention because encephalopathy risk is increased. To achieve these intervention objectives, LPPP managers must determine which LPPP stakeholders can respond, contact the parent/guardian and property owner, alert the LPPP stakeholder network, assess lead hazards in the victim’s environment, ensure the victim has a lead-safe dwelling, and monitor critical medical (e.g., treatment prognosis, VBLC reports, treatment discharge date, etc.) and environmental interventions (e.g., assure all lead-safe environment tasks are completed). This special report describes the DCHD protocol developed to ensure rapid environmental health responses to severe pediatric lead poisoning.


July 2018
July/August 2018
81.1 | 22-28
Larry W. Figgs, MPH, PhD, REHS/RS, Douglas County Health Department, Amy Bresel, DC, Douglas County Health Department, Khari Muhammad, Douglas County Health Department


We investigated an outbreak of eight Legionnaires’ disease cases among persons living in an urban residential community of 60,000 people. Possible environmental sources included two active cooling towers (air-conditioning units for large buildings) <1 km from patient residences, a market misting system, a community-wide water system used for heating and cooling, and potable water. To support a timely public health response, we used real-time polymerase chain reaction (PCR) to identify Legionella DNA in environmental samples within hours of specimen collection. We detected L. pneumophila serogroup 1 DNA only at a power plant cooling tower, supporting the decision to order remediation before culture results were available. An isolate from a power plant cooling tower sample was indistinguishable from a patient isolate by pulsed-field gel electrophoresis, suggesting the cooling tower was the outbreak source. PCR results were available <1 day after sample collection, and culture results were available as early as 5 days after plating. PCR is a valuable tool for identifying Legionella DNA in environmental samples in outbreak settings.

April 2018
April 2018
80.8 | 8-12
Isaac Benowitz, MD, Epidemic Intelligence Service, Centers for Disease Control and Prevention, Robert Fitzhenry, PhD, New York City Department of Health and Mental Hygiene, Christopher Boyd, New York City Department of Health and Mental Hygiene, Michelle Dickinson, MPH, New York State Department of Health


In the late 1980s it was discovered that the Pacific Northwest is sited in the Cascadia subduction zone, a fault capable of producing a magnitude 9.0 earthquake, which could result in significant destruction along the almost 700 miles of impact. One likely result of this earthquake would be a catastrophic impact to wastewater systems in the Portland metropolitan area, with anticipated loss of wastewater systems for 6 months–1 year. With approximately 2.3 million residents in the area, this loss poses a significant threat to the public’s health in the aftermath of an earthquake of this magnitude.

A group of multidisciplinary professionals from the five counties in the area was convened to develop recommendations to assist the public to safely handle their sanitation needs in the absence of a functional wastewater system for an extended period of time. Participants represented the disciplines of public health, emergency management, public works, wastewater treatment, waste hauling, and the Oregon Department of Environmental Quality. The group developed recommendations for the handling of human waste by residents of the Portland metropolitan region following a catastrophic earthquake. In this special report, we review the process, assumptions, and final recommendations for use by the public in a long-term wastewater system failure.


September 2019
September 2019
82.2 | 14-16
Susan Mohnkern, MPH, RN, Washington County Public Health, Ken Schlegel, Washington County Emergency Management, Erin O’Connell, REHS, Columbia County Environmental Services, Scott Johnson, MS, MEP, Clark Regional Emergency Services Agency
Additional Topics A to Z: Wastewater

Chuck Lichon, R.S., M.P.H., Deputy Health Officer at District Health Department #2 in Michigan, developed a Children’s Environmental Health Power Point Program with the financial assistance of the Dow Chemical Company, Midland, MI.  The Power Points are approximately 25-35 minutes in length, allowing for a presentation to be made during one classroom setting, or to be used for a community presentation, allowing time for Q & A.  Some of the topics include: Sunwise, Body Art, Household Hazardous Waste, Meth, Recreational Water, and more.  They are free to download and use for presentations in your school, health department community presentations, or for media use.  Changes in the presentations should not be made without consent from the author, and/or the NEHA Board of Directors.  

The Recreational Water PowerPoint is available via the link listed below:   

Chuck Lichon, R.S., M.P.H.
Additional Topics A to Z: Recreational Waters


Lead exposure causes an array of significant health problems in adults and especially in children. Therefore, reducing lead exposure is an important public health goal. Here, we analyzed data collected about the lead content in two product types, candy and purses. We show that following litigation, the prevalence of these products containing lead in California declined significantly. Results from products purchased online suggest that the decline was national, not just limited to California. Our results indicate that state consumer protection laws can be successful in reducing exposure to hazardous chemicals.


March 2019
March 2019
81.7 | 28-31
Caroline Cox, MS, Center for Environmental Health, Howard Hirsch, JD, Lexington Law Group
Additional Topics A to Z: Hazardous Materials


Repeated warnings by the scientific community on the dire consequences of climate change through global warming to the ecology and sustenance of our planet have not been give appropriate attention by the U.S. public. Research has shown that climate change is responsible for catastrophic weather occurrences--such as floods, tornadoes, hurricanes, and heat waves--resulting in environmental and public health issues. The purpose of this report is to examine factors influencing public views on climate change. Theoretical and political perspectives are examined to unpack opinions held by the public in the U.S. on climate change. The Health Belief Model is used as an example to showcase the efficacy of an individual behavior change program in providing the synergy to understand climate change at the microlevel. The concept of reframing is discussed as a strategy to alter how the public views climate change.

April 2017
April 2017
79.8 | 24-27
Caitlin Weems, MS, Department of Health Promotion and Physical Education, Ithaca College, Prithwi Raj Subramaniam, PhD, Department of Health Promotion and Physical Education, Ithaca College

A re-emergence of bedbugs and resultant impacts on community resources led to the convening of a “Bedbug Summit." Attendees represented professionals from a broad spectrum of affected sectors including housing providers, homeless-shelters, education, pest control services, public health, waste stream management, and social services. During the summit, this group worked together and identified collaborative approaches to address bedbugs in the region. The resulting Bed Bug Workgroup has made significant achievements including successful advocacy for additional funding, launching an information telephone hotline, developing a multi-lingual educational clearinghouse website, and identification of a collaborative surveillance system that protects pest control operators and the communities they serve. Attend this session to learn about how engaging nontraditional partners results in more robust environmental health outcomes and apply a community organizing model to emergent public health issues.

July 2015
Matt Davis, MPH, Christie  Sweitz, REHS
Potential CE Credits: 1.00

Article Abstract

Infants and young children under five years of age are uniquely vulnerable to certain environmental contaminants. Some of these contaminants have been found in early learning environments (ELEs), or child care and family child care settings where children spend an average of 40 hours a week. These contaminants as well as infants’ and children’s unique physiology, exposures, and behaviors in child care settings are the focus of this article. Current child care and family child care licensing requirements specific to environmental health–related issues are also reviewed. Data were reviewed and analyzed from the following surveys: the 2008 Child Care Licensing Survey, the First National Environmental Health Survey of Child Care Centers, and the Children’s Total Exposure to Persistent Pesticides and Other Persistent Organic Pollutants. The authors’ analysis suggests that current state licensing programs impose only the most basic environmental health protection requirements. No mandatory federal regulations standardize child care and family child care regulatory efforts nationally. Resources are available, however, from federal agencies and other children’s environmental health organizations that may provide guidance for how to establish better environmental health protection measures in ELEs.



March 2014
76.7 | 24-34
Gwendolyn Hudson, MPH, PhD, CPH, Gregory G. Miller, MS, Kathy Seikel, MBA
Additional Topics A to Z: Children's Environmental Health


Most foodborne illnesses reported to health departments originate from food service establishments. The District of Columbia Department of Health conducts periodic inspections to assess the risk of foodborne illness. The occurrence trends of priority violations and their relationships to foodborne illness and resident complaints have not yet been investigated in the District of Columbia. This research studied the relationship between foodborne illness complaints reported by patrons and observed priority violations in food establishments. This study used a nonexperimental quantitative methodology that relied on preexisting data, including food establishment inspection reports and health statistics. The results showed that observed priority violations in food establishment inspections in the District of Columbia were positively correlated with two Centers for Disease Control and Prevention-identified foodborne illness risk factors: poor personal hygiene and contaminated equipment. The study results showed that patron-generated foodborne illness complaints were significantly correlated with improper holding temperatures and contaminated equipment. This study can act as a motivator to reevaluate existing food safety inspection enforcement practices and thereby reduce foodborne illnesses in the District of Columbia.

April 2018
April 2018
80.8 | 14-19
Temesgen A. Jemaneh, MSc, DrPH, REHS, CP-FS, ASP, District of Columbia Department of Health , Mark Minelli, MA, MPA, PhD, Central Michigan University, Abimbola Farinde, PhD, PharmD, Capella University, Edward Paluch, PhD, Capella University